Endometrios är en sjukdom som drabbar många kvinnor, men som fortfarande är mycket missförstådd. Det uppstår när vävnad som liknar endometrium växer utanför livmodern och fäster sig vid andra delar av kroppen. Eftersom denna vävnad beter sig som normal endometrium som reagerar på hormonella förändringar kan den orsaka inflammation, smärta och en rad andra symtom som påverkar vardagen och reproduktiv hälsa.
För många kvinnor är det svårt att förstå endometrios eftersom symtomen varierar kraftigt. Vissa upplever svår smärta och märkbara förändringar i menstruationscykeln, medan andra kan ha väldigt få symtom alls. I vissa fall upptäcks tillståndet först vid undersökningar av fertilitet. Denna variation gör ofta diagnosen svår och bidrar till långa fördröjningar innan patienterna får svar.
Kort svar: Endometrios uppstår när vävnad som liknar endometriumn växer utanför livmodern, där den kan orsaka inflammation och smärta, vilka förvärras vid hormonella förändringar. Tillståndet kan uppträda i flera stadier, från lindrigt till allvarligt, beroende på hur djupt vävnaden växer och i vilken utsträckning den påverkar omgivande organ. Symtomen omfattar ofta smärtsamma menstruationer, kraftiga blödningar, matsmältningsbesvär och problem med fertiliteten, även om vissa personer kan uppleva mycket få symtom.
Livsstilen har betydelse för fertiliteten. En studie i BMC Public Health visade att kvinnor med 4–5 hälsosamma vanor hade 59 % lägre risk för infertilitet.
Fyll i frågeformuläret och få ett personligt, holistiskt och evidensbaserat program anpassat efter dig.
tar 3 minuter att fylla iEndometrios utvecklas när vävnad som normalt hör hemma inuti livmodern börjar växa i andra delar av kroppen. Denna vävnad liknar endometriumet och reagerar på hormonella förändringar under menstruationscykeln. När hormonerna fluktuerar beter sig vävnaden utanför livmodern på liknande sätt, vilket kan leda till inflammation och obehag.
Denna vävnad kan fästa sig på olika ställen i kroppen, bland annat på organ i bäckenhålan. När dessa utväxter utvecklas beskrivs de ofta som lesioner eller implantat. Dessa implantat kan utlösa inflammation, och den inflammationen kan göra att tillståndet gradvis förvärras med tiden.
En annan viktig aspekt av endometrios är dess samband med hormoner. Östrogen spelar en nyckelroll för att stimulera tillväxten av endometrial vävnad. Följaktligen har personer med endometrios ofta förhöjd östrogenaktivitet, vilket kan främja vävnadens tillväxt och bidra till en pågående inflammation.
Endometrios klassificeras också som en eftersom kroppen producerar antikroppar som cirkulerar i blodomloppet och interagerar med livmoderens egna vävnader. Dessa immunreaktioner kan bidra till den inflammatoriska miljön som gör att tillståndet kvarstår.
Endometrios begränsar sig inte till livmodern. Eftersom vävnaden kan fästa vid andra delar av kroppen kan den påverka flera organ och system. Detta är en av anledningarna till att symtomen kan variera så mycket mellan olika personer.
När endometriumvävnad växer utanför livmodern kan den bilda lesioner som fäster vid omgivande vävnader. Med tiden kan dessa lesioner orsaka inflammation och leda till att närliggande strukturer klibbar ihop. Dessa sammanväxningar kallas adhesioner.
Adhesioner kan förändra organens naturliga placering i bäckenhålan. I vissa fall kan äggstockarna eller äggledarna fästa vid annan vävnad. Detta kan störa den normala reproduktiva funktionen och bidra till problem med fertiliteten.
Att förstå hur endometrios påverkar den reproduktiva anatomin kan vara till hjälp för personer som funderar på frågor om fertilitet. Att lära sig mer om hur sjukdomar påverkar fertiliteten kan till exempel ge en användbar bakgrund när man läser om ämnen som Endometrios och infertilitet, där det förklaras hur endometrios kan påverka befruktningen och reproduktiva utfall.
Endometrios klassificeras vanligtvis i fyra stadier utifrån svårighetsgraden och djupet av vävnadstillväxten. Dessa stadier stämmer inte alltid perfekt överens med symtomen, men de hjälper läkare att bedöma hur omfattande tillståndet har blivit.
Innehållet är enbart i utbildningssyfte. Det har granskats för vetenskaplig korrekthet, men utgör inte medicinsk rådgivning, diagnos eller behandling. Rådfråga alltid legitimerad vårdpersonal vid medicinska frågor eller beslut om fertilitetsbehandling.
Granskad för vetenskaplig korrekthet av: Dr. Mona Bungum
Senast granskad: mars 2026
Livsstilen har betydelse för fertiliteten. En studie i BMC Public Health visade att kvinnor med 4–5 hälsosamma vanor hade 59 % lägre risk för infertilitet.
Fyll i frågeformuläret och få ett personligt, holistiskt och evidensbaserat program anpassat efter dig.
tar 3 minuter att fylla iStadie ett anses vara den mildaste formen av endometrios. I detta stadium förekommer endast ett fåtal ytliga implantat. Dessa implantat finns vanligtvis i de yttre lagren av endometriumet eller i närliggande vävnader.
Eftersom vävnadsinvolveringen är minimal kan symtomen vara milda eller ibland omärkbara. Men även endometrios i ett tidigt stadium kan fortfarande orsaka obehag hos vissa personer.
Stadie två innebär ett större antal implantat som sträcker sig djupare in i vävnadslagren. Sjukdomens spridning är fortfarande relativt begränsad, men lesionerna börjar tränga längre in under ytan.
I detta stadie kan inflammationen bli mer märkbar, och symtom som smärtsam menstruation kan bli vanligare.
Stadium tre kännetecknas av flera djupa implantat och eventuell utveckling av cystor på äggstockarna. Dessa cystor kallas ofta för endometriom eller ”chokladcystor”.
Förutom cystbildning kan tunna sammanväxningar börja utvecklas. Dessa sammanväxningar kan få organen i bäckenet att klibba ihop, vilket kan förändra reproduktionsorganens placering.
Stadie fyra utgör det mest avancerade stadiet av endometrios. I detta stadium förekommer många djupa implantat, och stora cystor kan bildas på ena eller båda äggstockarna.
Täta sammanväxningar kan utvecklas i hela bäckenhålan, vilket kan påverka organens struktur och rörlighet avsevärt. I allvarliga fall kan organen dras ur sin naturliga position på grund av omfattande sammanväxningar.
Förutom stadierna kan endometrios även klassificeras i kategorier beroende på var vävnaden växer och hur djupt den tränger in i omgivande strukturer.
Peritoneal endometrios är den mildaste formen av sjukdomen. I denna kategori växer endometriumvävnad på bukhinnan, det tunna membranet som klär bukhålan.
Även om denna form kan verka mindre allvarlig kan den ändå orsaka inflammation och obehag.
Endometrios i äggstockarna uppstår när cystor bildas på äggstockarna. Dessa ovarialcystor kallas ofta för chokladcystor eftersom de innehåller mörk vätska bestående av gammalt blod.
En risk med ovarialcystor är att om de brister kan endometriumvävnaden sprida sig i hela bäckenhålan, vilket kan förvärra tillståndet.
Djupinfiltrerande endometrios uppstår när vävnaden tränger djupt in i organen i bäckenhålan. Detta kan omfatta strukturer som äggstockarna, livmodern eller ändtarmen.
Eftersom vävnaden växer in i organen istället för att bara fästa vid deras yta kan denna form påverka bäckenregionens anatomi avsevärt.
I mer extrema fall kan djupt infiltrerande endometrios sträcka sig utanför bäckenhålan och påverka andra organ i kroppen. Vissa personer har diagnostiserats med endometrial vävnad som påverkar områden som tarmarna eller till och med avlägsna delar av kroppen.
Även om dessa fall är mindre vanliga belyser de hur komplex och utbredd sjukdomen kan bli.
Symtomen på endometrios varierar från person till person. Vissa personer upplever flera symtom, medan andra kanske bara har ett eller två märkbara tecken.
Smärtsam menstruation är ett av de vanligaste symtomen. För vissa kan smärtan vara måttlig, medan andra upplever svårt obehag under menstruationscykeln.
Smärtan kan uppstå innan cykeln börjar, under menstruationen eller till och med vid andra tillfällen under månaden.
Vissa personer med endometrios upplever långa menstruationscykler eller kraftig blödning. Mensen kan pågå längre än vanligt och kan innefatta mörkt blod eller stora blodproppar.
Dessa förändringar kan ibland tyda på störningar i de normala hormonella och inflammatoriska processerna i kroppen.
Eftersom endometriumvävnad kan växa utanför livmodern kan smärta också uppstå i andra områden beroende på var vävnaden är belägen. Vissa personer upplever obehag i bäckenet, buken eller andra delar av kroppen under sin cykel.
Hormonella svängningar under menstruationen kan påverka hur dessa vävnader beter sig, vilket kan förklara varför symtomen ofta förvärras under vissa perioder av cykeln.
En av de mindre kända aspekterna av tillståndet är något som kallas tyst endometrios. I dessa fall kan personer ha tillståndet utan att uppleva typiska symtom.
Ibland kan det enda märkbara problemet vara svårigheter att bli gravid. Eftersom symtomen saknas kan tillståndet förbli oupptäckt tills undersökningar av fertilitet avslöjar det.
Livsstilsfaktorer kan påverka hur tydliga symtomen blir. Till exempel kan personer som lever en livsstil som minimerar inflammation uppleva färre yttre symtom även om endometriumvävnad finns.
En av de mest frustrerande aspekterna av endometrios är hur lång tid det kan ta att få en diagnos. I genomsnitt väntar många mellan åtta och tolv år innan tillståndet identifieras korrekt.
En del av fördröjningen beror på missuppfattningen att smärtsamma menstruationer är normala. I själva verket kan ihållande eller svåra menstruationssmärtor tyda på en underliggande sjukdom som bör undersökas närmare.
Att verka för adekvat medicinsk vård är ett viktigt steg för att identifiera och behandla endometrios. Personer som upplever ihållande symtom bör uppmuntras att söka vård hos vårdgivare som tar deras bekymmer på allvar.
Endometrios är en komplex sjukdom som kan påverka många aspekter av en persons hälsa och vardagsliv. Att förstå vad sjukdomen innebär, hur den utvecklas och hur den fortskrider kan hjälpa personer att känna igen symtomen och söka lämplig vård.
Även om upplevelsen av endometrios varierar kraftigt är medvetenhet fortfarande ett avgörande första steg. Att känna igen symtomen, förstå stadierna och lära sig mer om de olika kategorierna av tillståndet kan hjälpa personer att fatta välgrundade beslut om sin hälsa.
Med rätt medvetenhet, stöd och medicinsk vägledning kan många som lever med endometrios bättre hantera sina symtom och utforska alternativ som främjar både deras allmänna välbefinnande och reproduktiva mål.
00:00:00 We're going to talk about what endometriosis is, the symptoms of endometriosis causes, and then we're going to shift the next time we talk the next part of the episode, we're going to talk about current technology and treatment from a Western standpoint and how it's treated from an integrative standpoint. We're also going to talk about other little known facts about endometriosis that a lot of women aren't aware of, and also some clinical pearls that I've found from treating it in my practice.
00:00:28 clinical pearls that I've found from treating it in my practice. I'm Caroline Ashurst. I'm so happy you're here. My goal is to give you help and the roadmap to help heal your fertility and get the support that you need. So the good news is that endometriosis diagnosis is not the end of your fertility. It doesn't mean you can't get pregnant. Um, it might be a little bit more of a curvy, twisty path to get there, but with the right providers and the right practitioners and treatments,
00:00:57 you can navigate this with empowerment and hope. you can navigate this with empowerment and hope. So what is endometriosis? Um, a lot of my ladies know what this is, and a lot of people struggle with endometriosis. So with endometriosis, what happens is that the tissue that's usually found in your endometrium, endometrial lining in your uterus, is found in other places in your body, outside of your uterus. So it's really only supposed to be in there.
00:01:28 So it's really only supposed to be in there. It's a specific kind of tissue that behaves a specific kind of way. It's responsive to responsive to hormones. It's responsive to many different things that are happening in the body. And that tissue is usually made out of fibrin. So the thing about endometriosis is that it does not only live in the uterus, it can attach itself outside of it. And that's essentially, um,
00:01:56 a lot of what we're looking at is like the lesions of the tissue inside a lot of what we're looking at is like the lesions of the tissue inside the uterus, but also outside of it. We're going to talk a little bit more about that. So, um, it causes systemic inflammation in the body and inflammation exacerbates it. So it's got this like cycle of repeating itself. Having it in and of itself causes inflammation. And then inflammation makes it worse. Um, so just like our uterus, again,
00:02:28 it responds to hormonal changes and behaves like endometrial tissue, it responds to hormonal changes and behaves like endometrial tissue, but in other parts of the body. So, um, some of these symptoms are what you would experience if you have, um, painful periods, you might get pain during your cycle, before your cycle and other places in your body. And this is actually one of the common symptoms we're going to talk about in a minute. Um, estrogen is required for endometriosis to grow.
00:02:54 So that's another part of this. You will oftentimes find high levels of estrogen in women who have endometriosis. And it is an autoimmune disease. So it is categorized as that because your body creates, uh, autoimmune antibodies when you have endometriosis, which then attack your own body cells. So, um, these antibodies circulate through your blood. Uh, and those are the attacking cells. So there are different stages of endometriosis.
00:03:27 So there are different stages of endometriosis. So depending on how, uh, how invasive and how, uh, how severe your, uh, endometriosis is, you will be in a certain stage. So stage one is very minimal, uh, instance of endometriosis. So there are a few superficial implants, um, the fibrin deposits in your uterus and superficial meaning that they're in the one of the top your uterus and superficial meaning that they're in the one of the top layers of the endometrial lining. Stage two is as mild and there
00:04:10 are more of the implants, and they are deeper in the tissue layers. Stage three is moderate. There's many of the deep implants. And there can be small chocolate. They're called chocolate cysts on the ovaries, one or both. And then there's presence of filmy adhesions. So these adhesions are the uh sticky filmy adhesions. So these adhesions are the uh sticky tissue that actually like glues, uh, your tissues together inside your body. So oftentimes there will be, um,
00:04:42 you know, sometimes we will find that there is, uh, the ovary is sticking to another part of the body, um, or that, you know, tissue is sticking together. It's almost like this glue, like tissue. Stage four is severe. There are many deep implants, like tissue. Stage four is severe. There are many deep implants, large cysts on one or both ovaries, and many dense adhesions like those filmy adhesions that we were talking about. So there are also different categories.
00:05:15 So there is peritoneal endometriosis and that is when it's the most minimal form. And the peritoneum is the membrane that lines the abdomen that is infiltrated with endometrial endometriosis tissue. Uh, so that's when it starts to, uh, endometrial endometriosis tissue. Uh, so that's when it starts to, uh, grow outside of the endometriosis. Um, endometrioma. Sorry. Uh, so category two is the ovarian aspect, the chocolate cyst that you'll find on the ovary. But one of the reasons why they're
00:05:50 particularly risky is because there's a risk of breaking and spreading the endometriosis within the pelvic cavity. If they if there is, uh, chocolate cyst activity happening. If they if there is, uh, chocolate cyst activity happening. Category three is deep infiltrating endometriosis, and that is the first form of deep infiltrating endometriosis that involves the organs and the pelvic cavity. So that could be the ovaries, the rectum, uterus. And this can significantly affect
00:06:18 and impact the anatomy of the organs because it distorts them. So, you know, sometimes you'll have fallopian tubes that are stretched out or ovaries that are pulled in different directions, or even your uterus will be tilted. Those kinds of things can happen or even your uterus will be tilted. Those kinds of things can happen when we have, uh, deep infiltrating endometriosis. The next one is, uh, the second version of deep infiltrating endometriosis. There's one and two. So this is two.
00:06:46 And this is a more extreme type that involves organs both within and outside the pelvic cavity. So that could be bowels, appendix, heart and lungs, among others. There are women that have endometriosis growing on their shoulders and in their back. endometriosis growing on their shoulders and in their back. Um, so we'll transition now to symptoms because that's like an obvious next step in this descriptive process that we're going through right now. So the symptoms of endometriosis
00:07:16 they're different for every woman. And something I want to say that's really important is that, you know, if you look at a symptom list, you do not need to have even more than 1 or 2 symptoms to have endometriosis. not need to have even more than 1 or 2 symptoms to have endometriosis. That does not mean that if you have painful periods, you have endometriosis, but it means that you like oftentimes people will be like, well, I don't have all of these symptoms or I don't have many of them. That doesn't matter.
00:07:44 And that does not mean that you do not have endometriosis. So, um, symptoms that are documented, symptoms that I've seen clinically are painful periods. And a lot of times we're talking about like five out of ten. Um. You know, could even be minimal. about like five out of ten. Um. You know, could even be minimal. But, you know, it can really range to ten out of ten and worse. Um, uh, nausea can happen sometimes when you have severe pain, uh, long periods, periods that last for a long time. Heavy periods.
00:08:23 Periods have a lot of clots, specifically dark colored clots, dark period blood. So in Chinese medicine we say dark period blood. So in Chinese medicine we say that that is blood stagnation. And though the symptoms for blood stagnation in Chinese medicine are the same symptoms for endometriosis. Um, and then, uh, pain, you know, pain in other parts of your body around your cycle. Um, again, our hormones change the way our tissue behaves in our body. Many different types of tissue, our
00:08:54 hormones impact our body's functions, and our hormones also impact our tissue and our abdomen. Right. Because we get pain during our tissue and our abdomen. Right. Because we get pain during our cycle sometimes. So you will have the same kind of pain in the other places in your body, around your cycle. So that's something to pay attention to. Um, another thing that's really important and actually very disappointing is that, uh, well, there's a few there's a few
00:09:23 different things. Um. Number one is that women are categorically gaslit about their symptoms by our standard intakes. categorically gaslit about their symptoms by our standard intakes. Um, you know, female doctors have an embodied somatic physical experience of having cycles and male, you know, usually don't. So, um, it's hard for them to understand the experience of women. And I found that, um, doctors believe that periods that are painful are And I found that, um, doctors believe that periods that are painful are
00:10:04 normal and they're not normal. We should not have painful periods. If you have a painful period, it means there's something going on that you need to look at. Um, so if you have been complaining of painful periods and your doctor writes it off as normal, please don't stop your questioning there. That leads me to my next disappointing part of what I wanted to share with you is that, um, what's true is that people who have this condition wait between 8 and 12 what's true is that people who have this condition wait between 8 and 12
00:10:37 years on average for a diagnosis, like, let that sink in 8 to 12 years to get a diagnosis. So if you're trying to get pregnant, first of all, you wanted to get pregnant yesterday. Second of all, you don't have that time to wait. So you really have to advocate for yourself and make sure you're talking to providers that take you seriously, that listen. you're talking to providers that take you seriously, that listen. And, uh, we're going to go into next time we talk, we're going to go into,
00:11:09 uh, diagnostic tools for this because it's a whole other conversation. Um, but here's what I want to say. Um, I want to add that there is, uh, you know, there's discrepancies in how people are treated and listened to by doctors. And what's true is that for listened to by doctors. And what's true is that for black women, this picture of waiting 8 to 12 years to get diagnosed is even worse. Uh, it research shows that 50%, uh, black women are 50% less likely to be diagnosed with endometriosis
00:11:47 than their white counterparts. So, um, this is something we really need to pay attention to. And if you're a black woman, you really have to, unfortunately, advocate for yourself more. you really have to, unfortunately, advocate for yourself more. And I really acknowledge that you are having to do that in every way, shape and form in your life in order to get the care and attention that you deserve. So why then I think what we're going to do, um, is we're going to stop there and we're going to
00:12:20 pick up tomorrow more about, uh, we're going to talk about causes, we're going to talk about treatment and, uh, any other anecdotal things. we're going to talk about treatment and, uh, any other anecdotal things. Another thing I wanted to say to you before we go, one of the most important things for me to tell you is symptomology just to tie a bow on the symptom conversation is that. There are something called silent endometriosis. Have you heard of it? Silent endometriosis is when you have zero symptoms of endometriosis. Uh, we're going to talk about
00:12:58 causes next time we talk. So there's a few things I want causes next time we talk. So there's a few things I want to talk about with that. But there is silent endometriosis, where maybe the only symptom you have is that you're not getting pregnant. I had a client who was very healthy. She was a nutritionist. She was a functional nutritionist. So she really ate healthy and she struggled getting pregnant. And she did not want to do IVF because it was against her beliefs. And throughout her process of
00:13:28 because it was against her beliefs. And throughout her process of diagnosing what was actually happening with her, they found out that she had silent endometriosis. She no symptoms other than not getting pregnant. And what I believe is happening is that, you know, you can have this silent endometriosis if you're living a really like healthy lifestyle. You've been for a while and you might have had a minimal incidence of it, right? You might have been in category one, you might have been stage one.
00:13:59 You might have been in category one, you might have been stage one. Um, and depending on how our lifestyle is and things that we're exposed to, right, that can trigger it to become more severe or to just downgrade. We'll talk about that more in the next episode about this. But she would have never known that she would have ever thought that she would have never investigated that. Um, but I believe that her lifestyle, her very, very, very low inflammation lifestyle prevented that from showing symptomology signs.
00:14:29 lifestyle prevented that from showing symptomology signs. And I believe that she didn't have a very severe case of it. Obviously she would have known, but it's almost like, you know, it's like if you feed the endometriosis with the things that trigger it and create more inflammation, it's going to get louder. So, um, I really want to share that with you because it's important. I don't want you to get, like, caught up in your head, like that's what might be happening. But if you've been on this journey
00:14:58 for years and years and years, you know, and you still don't for years and years and years, you know, and you still don't know what's going on, it might be something to consider.
